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WASHINGTON UNIVERSITY SCHOOL OF MEDICINE DIVISION OF GYNECOLOGIC ONCOLOGY PATIENT FORM Name Birth date Age Date / / Problems (please state the reasons you want to see your doctor in order of importance
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How to fill out gynecologic oncology health history

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How to fill out gynecologic oncology health history:

01
Start by gathering all relevant medical records and documents related to your gynecologic health. This includes any previous surgeries, diagnoses, treatments, and medications.
02
Provide detailed information about your personal medical history. This should include any past or current medical conditions, such as diabetes, hypertension, or thyroid disorders. Be sure to mention any gynecologic conditions you have been diagnosed with, such as endometriosis, uterine fibroids, or ovarian cysts.
03
Include information about your family medical history. This involves documenting any gynecologic cancers or other related conditions that your immediate family members have been diagnosed with. This includes your mother, sisters, and daughters.
04
Detail your reproductive history. Mention any pregnancies, miscarriages, or abortions you have had. Provide dates and outcomes if possible. Additionally, discuss any contraceptive methods you have used or are currently using.
05
Describe any symptoms or concerns you have been experiencing. This could include abnormal bleeding, pelvic pain, or any other changes in your menstrual cycle. It is important to be as specific as possible about the duration and severity of these symptoms.
06
Provide a comprehensive list of all medications you are currently taking, including prescription medications, over-the-counter drugs, and any herbal supplements or vitamins. Include the dosage and frequency of each medication.
07
Mention any allergies or adverse reactions you have had to medications or medical procedures in the past. This is crucial information for ensuring your safety during any future treatments.

Who needs gynecologic oncology health history:

Gynecologic oncology health history is necessary for any individual who is seeking or undergoing treatment for gynecologic cancers or related conditions. This includes women who have been diagnosed with cervical cancer, ovarian cancer, uterine cancer, or any other gynecologic malignancy. It is also important for individuals who have a family history of gynecologic cancers or those who may be at increased risk due to genetic predisposition. Gynecologic oncologists use this information to assess the patient's risk factors, plan appropriate screenings or preventive measures, and determine the most suitable treatment options. By providing a thorough and accurate health history, patients can ensure that they receive the best possible care and support from their healthcare team.

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